When stacking ZZZZs doesn't come easy

Kerry Pirtle used to wake up feeling more exhausted than when he
went to sleep. His wife would notice during the night when he
wasn't breathing and "punch" him, alerting him to breathe, he said.
The 50-year-old also snored profusely.

He was diagnosed with a sleep disorder commonly known as
obstructive sleep apnea six years ago. Sleep apnea, a potentially
life-threatening disorder, is when breathing is interrupted during
sleeping.

Pirtle is just one of the millions of people who suffer from
sleep disorders in this country. About 18 million Americans have
been diagnosed with sleep apnea, and about 10 million more have it
but don't realize it, said Kathleen McCann, communications manager
for the American Academy of Sleep Medicine. Half of those diagnosed
are 40 and older, she added.

At the time Pirtle was diagnosed, the standard treatment was a
mask about the size of those that scuba divers wear, he said. He
wasn't sure it would work because he is a little claustrophobic. So
the mask ended up sitting by the side of the bed more than on
Pirtle's head.

"I couldn't even get through wearing it for an hour," he
said.

But the interrupted sleep and worn-out feeling during the day
persisted to the point where he was ready to take on the world of
treatment again. He recently decided to get retested at a sleep
diagnostic center in Temecula and discovered that, as with most
things these days, the masks had gotten a lot smaller. While he
still feels a little claustrophobic with the downsized mask, he's
giving it another try.

"I usually put it on one hour before bedtime to get used to it,
but I haven't been able to fall asleep with it yet," he said of a
trial mask he got from the sleep center.

Two centers in Southwest Riverside County diagnose and treat
these disorders —— the Murrieta Sleep Medical Clinic, which has
been around for 11 years, and West Coast Sleep Diagnostics in
Temecula, which opened in October.

The awareness of sleep disorders has grown exponentially in the
past decade and can be attributed to organizations such as the
American Academy of Sleep Medicine and the Sleep Research Society,
said Dr. Delmer Henninger, a pulmonologist and director of the
Murrieta clinic.

There are organizations for patients such as the American Sleep
Apnea Association and even the Restless Legs Syndrome Foundation,
said Henninger, a board-certified sleep physician.

Types of sleep disorders

Sleep disorders can affect people at all ages, from 3 years old
to 100, said Chris Chastain, director of operations for West Coast
Sleep Diagnostics. Chastain, an X-ray technician, specializes in
children with sleep disorders.

Sleep problems can range from insomnia to narcolepsy, which is a
condition characterized by the frequent and uncontrollable desire
to sleep, to restless legs syndrome, which causes the legs to
twitch during sleep, causing discomfort and often waking the
sleeper.

The most common problem, however, is obstructive sleep apnea,
which is mainly caused by blockages or reductions in air flow in
the throat. At worst, it can be fatal: An autopsy on football great
Reggie White, who died in December, found that sleep apnea may have
contributed to his death.

For people with this ailment, the tissue in the back of the
throat collapses partially and prevents air from getting to the
lungs, McCann said. The tissue collapses because muscles in the
throat relax during sleep and gravity does its part by causing the
tongue to recede and block the airway.

"The blockage causes you to momentarily cease breathing, and it
can occur a few times a night or a few hundred times, depending on
the severity of the condition," McCann said.

The most obvious clue is a loud one: snoring. But just because
you snore doesn't automatically mean you have sleep apnea, Chastain
said.

A major symptom of sleep apnea is excessive daytime sleepiness,
he said. Spouses and partners of people with this kind of sleep
disorder can also be sleep-deprived because they're often kept
awake by the snoring, he added.

"Sometimes, after we treat the patient, the spouse starts
sleeping better, too," he said.

And sometimes, after one person in a relationship is diagnosed
with a sleep disorder, it turns out the other person has one too,
he said.

That was the case with Gail Banoczi, 60, of Murrieta.

Her husband was diagnosed with sleep apnea about a year ago due
to her being aware of the symptoms, she said. She persuaded him to
be tested, and once he was treated and finally sleeping well, he
noticed her snoring, she said.

"Given my choice, I would probably sleep 10-plus hours a day,"
she said. "Anytime I get in the car and start driving, I yawn a
lot. So he (convinced) me."

She was referred by a physician and ended up at West Coast Sleep
Diagnostics in May.

"If I can feel rested after just eight hours, like normal
people, instead of after 10 and feeling like I've been disturbed,
it would be nice," she said.

Treatments of sleep disorders

Patients usually find out they have sleep apnea or related
conditions by describing their symptoms to a physician, said Keith
Serzen, chief operating officer for the Americas for ResMed, a
Poway-based company that makes devices to treat sleep
disorders.

Doctors will usually not examine for sleep-related breathing
problems on routine checkups however, he said, so it's important
for people to tell their doctors about sleep problems. If a sleep
disorder is suspected, doctors will refer patients to a sleep
clinic for testing by sleep specialists where they typically spend
a night or two.

West Coast Sleep Diagnostics has two bedrooms that exude a
peaceful, Zen-like atmosphere —— a comforting ambience considering
the degree to which patients have to be hooked up, strapped up and
monitored.

At the center, electrodes are attached to the scalp, a nasal
sensor goes under the nose, and bands go over the chest and stomach
to monitor breathing. An EKG is done to examine the heart rate, and
wires are attached to the legs to monitor restless legs
syndrome.

Once the data is gathered, doctors typically interpret the
results; in Chastain's case, he uses a doctor outside of the center
to read the information, he said.

The common treatment for obstructive sleep apnea is known as
continuous positive airway pressure, which is provided by a mask
that goes over the nose and blows a stream of air through it into
the airway.

"By blowing air through the nose, it keeps (the airway) open so
they breathe the way they're supposed to and their oxygen level
stays elevated and they feel great," Chastain said.

If this type of device is called for, patients are given a
prescription to be filled. They will be fitted with a mask that
matches their facial structure to form a tight seal.The masks range
in cost from about $175 to $235, said Dan Rubin with Innovative
Respiratory Care in Murrieta. They are typically paid for by
insurance companies, according to Chastain.

Most people have to wear the mask for the rest of their lives,
Chastain said. Sometimes, losing a significant amount of weight
will eliminate the need for it, but skinny people are susceptible
to sleep apnea, too, he said.

If the mask is too uncomfortable, surgery is an option, Chastain
said.

When interviewed recently, Pirtle said he will forge ahead with
the mask and is optimistic he will be able to sleep while wearing
it.

"It may take a little to get used to turning and tossing with
(the mask), but there shouldn't be a problem with it," he said.

Learn more

More than 70 million people in the United States suffer from
sleep disorders, according to the American Academy of Sleep
Medicine. Most don't know they have one, and the majority of those
who suspect it don't take the time to get diagnosed and
treated.

The most common disorders include:

Sleep apnea, which is characterized by breathing being
interrupted during sleeping.